1. Field of the Invention
This invention relates to the field of automated service request and fulfillment systems, particularly systems in which requests are made and fulfilled over a computer network.
2. Description of the Related Art
The health care industry and its endlessly spiraling costs are subjects of great concern at present, with new methods of managing medically-related information introduced regularly. A labor intensive approach has traditionally been taken to manage such information: a doctor orders a medical procedure on a multi-ply form, and a copy is delivered to a medical center by the patient, a courier, or via facsimile or mail. The results are returned to the doctor in similar fashion, recorded on paperwork which is physically carried back to the ordering doctor's office. Verifying a patient's medical insurance status traditionally requires that personnel working in a doctor's office or health care facility consult the latest revision of an insurer's printed "eligibility" list, or attempt to learn the status via telephone.
In the "managed health care" operating environment favored by health maintenance organizations (HMOs), member doctors typically must request and receive "authorization" from a patient's HMO prior to performing a particular medical procedure. The request for authorization, and its subsequent approval or denial, are commonly handled with an exchange of paperwork, via the mails. Similarly, permission to refer a patient to another doctor is usually requested and received via mailed or hand-delivered paperwork.
Many modern offices have attempted to improve their efficiency by introducing computers. A myriad of "complete medical office management" software products are in use which keep track of patient information and medical histories, billing and insurance information, etc. These products generally place such information into "data records" which are stored in one or more databases within a personal computer. The "format" of the information in a data record, i.e., the precise arrangement of text, data, and control characters which make up the record, is unique to most of the products in the market, as is the way in which the data records are arranged into a database. When an office adopts a new management system, a transfer of the stored information from the existing database to a new database is necessitated. However, because of the differences in the data record and database formats of the old and new products, such a transfer is typically accomplished by manually re-entering data into the new database one record at a time.
Some offices have linked their computer systems to various insurance providers via costly, proprietary computer networks, for purposes of determining insurance eligibility, for example. However, as with the office management software products, most of the existing network systems are unique, with each system having its own set of system requirements, operating procedures, and communications protocols. Confidentiality is also a serious concern when using a network, and while some network-based systems do encrypt the data sent over the network, the quality of the various encryption schemes and the procedures associated with them tend to vary widely. Also, many of these networks are arranged so that their user interface screens must be downloaded into the office computer over the network, which often results in long delays and poor responsiveness for the user due to the large amount of data that must be transferred over the network.
Similar problems and attempted solutions are found in other professional fields. For example, a brokerage may store investor identification and portfolio information in a database of some sort. The brokerage may need to communicate with a variety of off-site service providers, such as financial exchanges, quotation services, etc. As in the medical field, many software products and proprietary networks have been introduced to improve the management of financial information, but the vast technical differences which exist between competing products tends to also provide a host of incompatibility, upgrading and training problems.